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 Dr. George Jacob
Heart Infocenter


Angiotensin II Antagonists Reduce Blood Pressure While Avoiding Stroke and Diabetes

March 2002: A study that compared Cozaar and atenolol, two widely used blood pressure pills, found that patients on Cozaar were 25 percent less likely to suffer strokes and 25 percent less likely to develop diabetes. The two drugs lowered patients' blood pressure virtually identically.

The study involved 9,193 men and women with hypertension in Scandinavia and the United States. All had signs of thickening of the heart's main pumping chamber, a symptom of possible blood pressure damage.

During almost five years of follow-up, there were 232 strokes among patients on Cozaar, compared with 309 in those taking atenolol. In addition, 241 of the Cozaar patients developed diabetes, as did 319 on atenolol.

Cozaar appeared to be especially effective in those who already had diabetes. Their risk of dying from cardiovascular disease was 37 percent lower than the atenolol patients'.

Typically, doctors are satisfied simply to get patients' high blood pressure down. Not much thought is given as to how the blood pressure is reduced or what kind of drugs are used for it. This study shows that how blood pressure is lowered can be important, too.

In the United States, about 3.9 million people suffer from these conditions. According to the researchers, putting all of them on Cozaar instead of atenolol would prevent an additional 66,000 strokes and 54,000 new cases of diabetes annually.

Atenolol or Tenormin is one of many beta blockers that are widely prescribed after heart attacks. Cozaar is the first of a newer class of blood pressure medicines known as angiotensin II antagonists.

It is recommended that heart attack victims who also have high blood pressure should take both medicines. Cozaar reduces the heart wall thickening, while at the same time lowers the uric acid. This may explain the beneficial effects of using Cozar.

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